H1N1 School Closings in Donetsk Ukraine
Recombinomics Commentary 23:20
January 25, 2010

With regard to the incidence of seasonal flu and SARS, the incidence rate in the region has reached the epidemic threshold (53.2%), noted in the SES. And the most disease-prone age group - children of school age.

In connection with the elevated incidence of acute respiratory suspended the educational process in 5 schools and one boarding schools, 78 classes of 27 schools and three groups in three pre-school educational institutions

The above translation describes the closing of schools in Donetsk, Ukraine (see map) because the incidence of influenza/ARI has reached the epidemic threshold.  This level was reached in most regions of Ukraine earlier, but the latest report lists 4 oblast above the epidemic threshold, with 4 more approaching the threshold.  The other 19 regions, including Donetsk are below, and in a relatively safe zone.  Donetsk has been a concern because of the dramatic rise in fatalities.  The total of 162 to date is well above Lviv, which has 105.  The rise in Donetsk has been recent.  At the end of 2009 there were 91 deaths and 329,281.  This month the number of deaths has almost doubled to 162, which the number of cases has only increased about 20%.  Thus, instead of just under one in 4000 cases dying, the rate this month is closer to 1 in 1000.  This rate increase of almost four fold raises concerns that D225G/N are becoming more common in eastern Ukraine.

Today Mill Hill released 28 HA sequences from autopsy lung samples, and 21 had D225G, D225N, or both.  Of the 30 cases with D225G/N, 29 were from fatal cases.  This high fatality rate raises concerns that an increase in D225G/N levels will lead to a pronounced increase in severe or fatal H1N1 cases and reports of school closings in Donetsk due to a rise in cases raises concerns that the number of fatalities will significantly increase in the near term.

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